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Deactivated NPI 1366677510 Deactivated / Inactive NPI Male Practitioner

Jack Regan Grady , D, PM

Podiatrist • Fairview Park, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jack Grady has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 18, 2009
NPI Deactivation Date January 03, 2018
Total Practice Duration ~9 Years of Practice (2009 – 2018)

Professional Overview & Biography Verified Profile Summary

Jack Grady, D, PM was a registered Podiatrist practicing in Fairview Park, OH. Throughout an active medical career spanning 9 years, Jack Grady provided care at the practice location at 20800 WESTGATE MALL until profile deactivation on 2018-01-03.

Historical Medicare Part B clinical services included removal of noncancer thickened skin growth, 2-4 growths, removal of fingernails or toenails, 1-5 nails, trimming of dystrophic nails, any number. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

20800 Westgate Mall
Suite 401

Fairview Park, OH 441261323

Telephone 4404789434
Associated Practice Facility / Clinic
🏢 Classic Medical Staffing,llc Facility NPI 1821329590

Specialty Benchmarks & Practice Insights

Comparative analytics for Podiatrist in Fairview Park, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 29.8 Yrs
State Avg: 27.2 Yrs
Regional Practice Density
7 Specialists

Practicing in Fairview Park, OH (595 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
18.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
11056 Removal of noncancer thickened skin growth, 2-4 growths
358 153 $56.00 $50.53
11720 Removal of fingernails or toenails, 1-5 nails
303 145 $31.13 $28.68
G0127 Trimming of dystrophic nails, any number
296 142 $22.09 $11.73
11721 Removal of fingernails or toenails, 6 or more nails
187 103 $44.03 $40.30
99213 Established patient office or other outpatient visit, typically 15 minutes
63 41 $71.62 $65.75
11057 Removal of noncancer thickened skin growth, more than 4 growths
49 31 $63.00 $58.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more
32 32 $106.00 $97.42
11042 Removal of skin and tissue, 20.0 sq cm or less
31 12 $116.68 $53.99
Q4038 Cast supplies, short leg cast, adult (11 years +), fiberglass
26 14 $41.00 $40.35
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more
23 22 $43.00 $38.81
11042 Removal of skin and tissue, 20.0 sq cm or less
23 11 $113.00 $99.13
10060 Simple or single drainage of skin abscess
18 15 $114.00 $102.11
99213 Established patient office or other outpatient visit, typically 15 minutes
16 11 $73.44 $46.49

Medical Specialties & State Licenses

Podiatrist Primary Specialty

NUCC Taxonomy Code: 213E00000X

State License OH 36003597

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
Christine Stives , CCC-SLP

Speech-Language Pathologist

NPI 1164672143

Speech-Language Pathologist (Certificate of Clinical Competence)

NPI 1376567446

Doctor of Dental Surgery

Dr. Robert Klaus , MD

Obstetrics & Gynecology

NPI 1487609293

Doctor of Medicine (M.D.)

Mark Boyle , OTR, L

Occupational Therapist

NPI 1588967665

Occupational Therapist Registered, L

Sara Solet , MA, CCC-SLP

Speech-Language Pathologist

NPI 1710070107

Master of Arts, Speech-Language Pathologist (Certificate of Clinical Competence)

Allison Widman , OTR, L

Occupational Therapist - Pediatrics

NPI 1720474653

Occupational Therapist Registered, L

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 03, 2018

Record deactivated on January 03, 2018

NPI Profile Active March 22, 2016

NPI status registered as active in NPPES database

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Updated Practice Location March 22, 2016

Registered at 20800 WESTGATE MALL, SUITE 401, FAIRVIEW PARK, OH 441261323 (Tel: 4404789434)

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Updated Business Mailing Address March 22, 2016

Registered at 20800 WESTGATE MALL, SUITE 401, FAIRVIEW PARK, OH 441261323 (Tel: 4403337722)

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Provider Name / Credentials Updated March 22, 2016

Recorded as JACK GRADY, D,P.M

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2016

Podiatrist (License #36003597 in OH)

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Initial NPI Registration & Enumeration May 18, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1366677510
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 18, 2009
Last Update: March 22, 2016
Deactivation Date: January 03, 2018

Mailing Address

20800 Westgate Mall, Suite 401

Fairview Park, OH 441261323

Phone: 4403337722

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.